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Cyborg

Symlin

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Dewey
I looked up the package insert on Symlin and it does recommend 20 u of Symlin for Type 2 but only 10 for Type 1. Here is the link:

 

http://www.symlin.com/pdf/SYMLIN_Medication_Guide_B.pdf

 

Look at the bottom of page 2 and page 3. Doesn't really explain why.

Thank you both for the info, jillsp and Cyborg! :thumbsup: Truthfully, I'm leery of trying some of the newer drugs cause of all the side effects they seem to carry with them (i.e. Lantus, Symlin, Apidra - I tried Apidra & experienced some strange side effects).

 

Thanks again for your help on this topic.

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Cyborg

The thing that attracted me to the Symlin is that it is a synthetic form of a hormone that a healthy pancreas' beta cells normally put out along with insulin. They actually work together to control your bg, so to me it just makes sense to use this as therapy. I don't think they have enough information available on variable dosing, etc.

 

I posted the question earlier to see if anyone else had heard of it, but I did hear that some people were mixing it in their pumps. I know there was at least one study done on mixing in a syringe. I also don't understand why we need to eat 30 g of carbs to take it. I called the support line once for help and could only arrange for a callback. Either they never called or they didn't leave message while I was out.

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jillsp

Maybe you have to eat 30 g of carbs with Symlin b/c of the way it works...right? B/c it helps or interferes with absorption? It might not really do anything if you don't eat? I have no idea, just taking a stab in the dark. I'm still debating on whether I want to try it or not. I don't want to have to deal with shots again and dragging all that crap around with me. Do you guys find that it is really worth it?

 

Dewey, do you mind me asking what kind of side effects you had with Apidra? I'm just curious. I"ve only been on it for about a month and the biggest difference I saw compared to Humalog is I need a lot less Apidra than Humalog. Thanks!

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jillsp

Ok, I looked back at the prescribing information and in Symlin's Mechanism of Action it says that it has the following effects: 1) modulation of gastric emptying 2)prevention of the postprandial rise in plasma glucagon 3) satiety leading to decreased caloric intake and possible weight loss.

 

So, that makes sense, Symlin can't do these things unless you have eaten.

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Cyborg
So, that makes sense, Symlin can't do these things unless you have eaten.

 

 

Right, but I can eat a big meal that is less than 30 g of carbs. I'm curious as to any research with regards to action of the natural hormone amylin. How is it naturally released and used? Apparently, it's been around for awhile...

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Dewey
Maybe you have to eat 30 g of carbs with Symlin b/c of the way it works...right? B/c it helps or interferes with absorption? It might not really do anything if you don't eat? I have no idea, just taking a stab in the dark. I'm still debating on whether I want to try it or not. I don't want to have to deal with shots again and dragging all that crap around with me. Do you guys find that it is really worth it?

 

Dewey, do you mind me asking what kind of side effects you had with Apidra? I'm just curious. I"ve only been on it for about a month and the biggest difference I saw compared to Humalog is I need a lot less Apidra than Humalog. Thanks!

I don't mind sharing....Now, this is only personal experience, so each person's situation will vary, but when I took Apidra, I started getting pimples on my face (something I never get!!!), a constant sensation of needing to pee (no matter what my sugars were) and almost a feeling of having a "bladder infection" (which wasn't the case). I tried Apidra for a period of time (it was about 2 months or so), and when I found it wasn't helping sugars drop any faster than Humalog, I went back to my other insulin (until I got on Novolog).

 

The whole reason I chose to switch in the first place, was that I was experiencing fluctuations on Humalog. However, I later found the reason this was happening, was because the Humalog was sitting out either prior to shipment or during transit. This caused potency to drop, so by the time I received it, it almost wasn't working.

 

I'm now on Novolog and it's working well. I would have loved to stay on Humalog, but couldn't deal with all the fluctuations (especially at a time when I was helping my friend through his stem cell transplant).

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jillsp

Thanks Dewey, you had some crazy side effects!!!! I think it's so interesting to see how differently we all react to everything. That's what freaks me out about trying Symlin. I have a very weak stomach so am afraid I can't hack it. Plus, I would really be taking it to lose weight which makes me feel like a chump b/c why don't I just drag my fat butt to the gym instead?!?!?!? I would lose weight and lower my insulin requirements, which are already pretty low!!!! I think I'll go eat a cookie instead......

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Angelique

Very interesting what I am seeing today. I have results from bloodwork done back in late February while on Symlin and I have blood work from last week when not on Symlin and I find that my liver function panel differed considerably. The one with me on Symlin showed my SGOT (AST) whatever that is was 38 and in range is 5-35. Now, my recent blood work shows my SGOT is 14. Very interesting.

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Altonia

Hi,

New to all this---(though diabetic: type 2) for about 13 years.

 

Have just been reading a little about Symlin--and I understand one's A1C's have to be 9 or under in order to take it. Is that still the case? Changes occur so rapidly in meds that it could have changed from the time I first read about it.

 

I put on a lot of weight when I went on Humalog and THAT after a 30 pound loss!! Struggled to lose the weight and was doing very well--and then it all went south. 30 pounds PLUS back on!! Symlin is tempting--if I am suited to it. Haven't mentioned it to my Dr. yet--wanted to research it a little, first.

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gettingby
Hi,

New to all this---(though diabetic: type 2) for about 13 years.

 

Have just been reading a little about Symlin--and I understand one's A1C's have to be 9 or under in order to take it. Is that still the case? Changes occur so rapidly in meds that it could have changed from the time I first read about it.

 

I put on a lot of weight when I went on Humalog and THAT after a 30 pound loss!! Struggled to lose the weight and was doing very well--and then it all went south. 30 pounds PLUS back on!! Symlin is tempting--if I am suited to it. Haven't mentioned it to my Dr. yet--wanted to research it a little, first.

Hi Altonia. The Symlin website still says that you need to have an A1C under 9.

Check out the website:http://symlin.com

Hope this helps some.

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Cyborg
Hidden

I do a 40/60 and usually over 2 hrs, but sometimes 2 1/2...

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Jorj Gaidin

So I've been on Symlin a month now and my sugars are averaging 100. I've been so happy with the results, I've convinced many of my other pumping friends to start Symlin.

 

I've just been experiencing one problem that I'm wondering if anyone else has had. I will start a meal at about 80 and give myself symlin and insulin for the meal (with a 2hr square wave). however, I frequently find that I go low within 30 min of giving the insulin. Aside from actually delaying my bolus (I'm afraid I might forget) is there another way to avoid the lows? Has anyone else experienced this phenomenon?

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Cyborg
So I've been on Symlin a month now and my sugars are averaging 100. I've been so happy with the results, I've convinced many of my other pumping friends to start Symlin.

 

I've just been experiencing one problem that I'm wondering if anyone else has had. I will start a meal at about 80 and give myself symlin and insulin for the meal (with a 2hr square wave). however, I frequently find that I go low within 30 min of giving the insulin. Aside from actually delaying my bolus (I'm afraid I might forget) is there another way to avoid the lows? Has anyone else experienced this phenomenon?

 

What percentage is your combo bolus?

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Jorj Gaidin
What percentage is your combo bolus?

 

100% over 2hrs. I don't give myself any insulin immediatly. I've checked my BG and my sugars don't budge for about 1hr after eating. After that they only go up about 30-40 pts. They come down to about 90 within 3hrs after eating.

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Shotokan
I've just been experiencing one problem that I'm wondering if anyone else has had. I will start a meal at about 80 and give myself symlin and insulin for the meal (with a 2hr square wave). however, I frequently find that I go low within 30 min of giving the insulin. Aside from actually delaying my bolus (I'm afraid I might forget) is there another way to avoid the lows? Has anyone else experienced this phenomenon?

 

I had a similar problem taking Symlin with lunch. One day I took Symlin, but forgot to bolus, ate 60 carbs for lunch, and still went low! I speculated that it was potentiating my basal insulin. Rather than mess with my basal insulin my endo just advised me to stop taking Symlin with lunch. I still take it with breakfast and dinner and it works great.

 

It's also been suggested that I could take more than 10 units of Symlin even though I'm type 1. Have any type 1's tried more than 10 units?

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Cyborg
It's also been suggested that I could take more than 10 units of Symlin even though I'm type 1. Have any type 1's tried more than 10 units?

 

I've been taking 12 1/2 units.

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Shotokan
I've been taking 12 1/2 units.

 

I'm going to increase mine as well. My endo's PA, who is also a CDE, told me that she didn't see any reason why I couldn't increase the dose. My present dose is working great for breakfast, but I think I could improve my post-dinner BGs.

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Cyborg
I'm going to increase mine as well. My endo's PA, who is also a CDE, told me that she didn't see any reason why I couldn't increase the dose. My present dose is working great for breakfast, but I think I could improve my post-dinner BGs.

 

I was attempting to get some more duration out of it.

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Jorj Gaidin

It seems like if you are going low after eating, presumably because your insulin is working too quickly, what you are looking for is a more rapid release of sugar (i.e. less symlin). Am I thinking about this the wrong way?

 

 

I'm beginning to think that perhaps lispro (novalog) is not the right insulin to compliment symlin.

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Jorj Gaidin

Update on my Symlin experiment.

 

I've had my A1C tested after 1 month on Symlin. It was 6.1 down from 6.7. I suspect it will be below 6 in 3 months when I have it tested again. My BG averages are about 100ish from day to day.

 

I did ask my doctor about how to deal with low BG's 30-60 minutes after meals. She recommended (and I can't believe I didn't think of this) that I just take less Symlin. I've tried this and it works perfectly. So I'm taking 8 units of Symlin before meals now and about 80% of my pre-Symlin insulin.

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Cyborg
She recommended (and I can't believe I didn't think of this) that I just take less Symlin.

 

But according to your previous post, you did think of it! :)

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koblenz

OK, here is MY Symlin update...

 

Been on it for about 6 months or so now. After initial "break in" period, going great. I only take it with breakfast, 5 units.

 

About 2 or so weeks ago, I started noticing a 2.5 hour post breakfast reading of low 200's. Yikes. I had not seen that in like 5 months. No problem, extra bolus, fine by lunch. Next couple day, same thing. I had not changed my routine one bit. So I suspected bad bottle of symlin and switched. No dice, still going high. So I decided to adjust my insulin and see what happens. If that didn't work, adjust symlin. If that doesn't work, ask you guys. If that doesn't work, e-mail endo.

 

65 carb breakfast

 

Before: 5.2 units total, 40% immediate, remaining 60% over 1.5 hours

After: 6.9 units total, 20 % immediate, remaining 80% over 1.5 hours

 

Took a few days of experimenting, but I am back to my old no-post-breakfast-spike self. Don't really know why, but I suddenly (over the course of a few days) needed more insulin in the morning to cover breakfast. Lunch ratios didn't change. Dinner ratio's didn't change.

 

I have been on this new amount for about 1.5 weeks and all is well. WEIRD!

 

Oh, wait.... did I just feel the planets re-align? That's it! Stupid planets.

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Jorj Gaidin

Interesting....

 

My levels started going weird about 2 days ago... almost the same thing you're talking about. The only thing that's changed for me is I've switched to the Cozmo... but the rates and durations and everything is exactly the same. Except now I'm running high 2 hours or so after meals.... hmmm...

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Jorj Gaidin

I changed my insulin:car ratios yesterday much like it sounds like you did Koblenz. My sugars are right back down to where they were before. I have no idea why it happened, but things seem to be back to normal (except I'm using more insulin... 100% of my pre-symlin dosage).

 

I also discussed this issue with my pump rep. He mentioned that there have been some documented cases of people developing resistance to symlin. Has anyone else heard of this occuring?

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